Aortic reconstruction in high-risk pulmonary patients

J. G. Robinson, W. C. Beckett, Joseph L Mills, B. M. Elliott, R. Roettger

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Seventeen patients with clinical chronic obstructive pulmonary disease (COPD) who required aortic reconstruction underwent preoperative pulmonary function testing that categorized them as extremely high risk for pulmonary complications. Ten patients (Group 1) received perioperative steroids and seven patients (Group 2) received no perioperative adjunctive steroids. The mean forced expiratory volume (FEV 1) was 45% of the predicted value in Group 1 patients and 47% in Group 2 patients. The forced expiratory flow (25% to 75%) was severely restricted in both groups: 0.47 liters per second in Group 1 (16% ± 6% predicted value) and 0.53 liters per second (20% ± 7% predicted value) in Group 2 patients. Using a regimen consisting of preoperative pulmonary physiotherapy, optimization of theophylline levels, and early postoperative extubation of theophylline levels, and early postoperative extubation with initiation of postoperative physiotherapy resulted in survival in all cases. There did not appear to be a clear advantage to the use of adjunctive perioperative steroids. The overall incidence of pulmonary complications was 22%. Four patients died during the follow-up interval. The remaining 13 patients were alive at a mean follow-up interval of 35 months. Using a number of adjunctive techniques, succesful aortic reconstruction can be accomplished in many patients with severe COPD, and the majority will survive for extended periods after operation despite their impaired pulmonary function.

Original languageEnglish (US)
Pages (from-to)112-117
Number of pages6
JournalAnnals of Surgery
Volume210
Issue number1
StatePublished - 1989
Externally publishedYes

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Lung
Steroids
Theophylline
Chronic Obstructive Pulmonary Disease
Forced Expiratory Volume
Survival
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Robinson, J. G., Beckett, W. C., Mills, J. L., Elliott, B. M., & Roettger, R. (1989). Aortic reconstruction in high-risk pulmonary patients. Annals of Surgery, 210(1), 112-117.

Aortic reconstruction in high-risk pulmonary patients. / Robinson, J. G.; Beckett, W. C.; Mills, Joseph L; Elliott, B. M.; Roettger, R.

In: Annals of Surgery, Vol. 210, No. 1, 1989, p. 112-117.

Research output: Contribution to journalArticle

Robinson, JG, Beckett, WC, Mills, JL, Elliott, BM & Roettger, R 1989, 'Aortic reconstruction in high-risk pulmonary patients', Annals of Surgery, vol. 210, no. 1, pp. 112-117.
Robinson JG, Beckett WC, Mills JL, Elliott BM, Roettger R. Aortic reconstruction in high-risk pulmonary patients. Annals of Surgery. 1989;210(1):112-117.
Robinson, J. G. ; Beckett, W. C. ; Mills, Joseph L ; Elliott, B. M. ; Roettger, R. / Aortic reconstruction in high-risk pulmonary patients. In: Annals of Surgery. 1989 ; Vol. 210, No. 1. pp. 112-117.
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